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SEEG re-exploration in a patient with complex frontal epilepsy with rapid perisylvian propagation and mixed "startle - reflex" seizures

Abstract : The SEEG International Course, organised in 2017, focused on the investigation and surgery of insulo-perisylvian epilepsies. We present one representative complex case that was discussed. The patient had seizures displaying startle/reflex components. He was MRI negative, while other non-invasive investigations offered only partially concordant data. Initial SEEG exploration resulted in an incomplete definition of the epileptogenic zone. A second SEEG followed, which led to a thorough assessment of the seizure onset zone and the epileptic network, localised to the lateral inferior premotor cortex, explaining the incongruent data obtained beforehand. This was the basis of a tailored resection with a favourable outcome. The patient has been seizure-free for five years without any motor nor cognitive deficits, but with pharmacodependence to one AED. The electroclinical reasoning is presented, accompanied by relevant commentaries and recommendations from the tutors [Published with video sequences].
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https://hal.archives-ouvertes.fr/hal-03156503
Contributor : Laurent Jonchère Connect in order to contact the contributor
Submitted on : Tuesday, March 2, 2021 - 2:59:39 PM
Last modification on : Wednesday, January 5, 2022 - 4:52:13 PM

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Mihai Dragos Maliia, Philippe Kahane, Anca Nica, Ioana Mindruta, Laura Castana, et al.. SEEG re-exploration in a patient with complex frontal epilepsy with rapid perisylvian propagation and mixed "startle - reflex" seizures. Epileptic Disorders, John Libbey Eurotext, 2021, 23 (1), pp.180-190. ⟨10.1684/epd.2021.1246⟩. ⟨hal-03156503⟩

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